Related Experiment Video
Updated: Jan 14, 2026
A Syngeneic Pancreatic Cancer Mouse Model to Study the Effects of Irreversible Electroporation
Published on: June 8, 2018
Morcellation Efficiency Across Prostate Size Categories in Holmium Laser Enucleation of the Prostate (HoLEP): A
Momen Sid Ahmed1, Nkwam Nkwam1
1Department of Urology, King's College Hospital NHS Foundation Trust, London, GBR.
Background:
Mechanical morcellation is integral to Holmium Laser Enucleation of the Prostate (HoLEP). Understanding how morcellation efficiency varies with gland size can inform list planning, device selection, and safety preparedness.
Objective:
To quantify morcellation efficiency across preoperative prostate size categories and examine its association with gland volume.
Methods:
We performed a retrospective, single-centre, complete-case analysis of 255 consecutive HoLEP procedures at a UK tertiary centre (January 2022-January 2025). Preoperative transrectal ultrasound (TRUS) prostate volume was categorised as <80 cc, 80-150 cc, and >150 cc. Morcellation efficiency (g/min) was calculated as enucleated tissue weight divided by morcellation time. Group differences were assessed nonparametrically with Kruskal-Wallis and Bonferroni-adjusted pairwise tests, and the relationship between volume and efficiency was evaluated with Spearman's ρ.
Results:
Size distribution was <80 cc 51 (20.0%), 80-150 cc 141 (55.3%), and >150 cc 63 (24.7%). Median morcellation efficiency decreased across categories: 9.02 (IQR 6.37-13.25) vs 8.71 (IQR 6.00-12.21) vs 7.00 g/min (IQR 4.25-9.57) (Kruskal-Wallis H=13.23, p=0.001); pairwise differences were significant for <80 vs >150 (p=0.005) and 80-150 vs >150 (p=0.003), but not <80 vs 80-150 (p>0.999). Efficiency inversely correlated with volume (ρ=-0.26, p<0.001).
Conclusions:
Morcellation efficiency decreases as glands become very large (>150 cc); anticipating slower retrieval in mega-prostates can guide list composition, staffing, and morcellator/technique choice.
